A woman collapses in front of a police barricade during one of the Occupy Gezi protests. Credit: Arzu Geybulla/IPS

By Ariam Frezghi
ISTANBUL, Jul 13 2013 (IPS)

Among the many issues bringing protestors together at Gezi Park, the now-iconic site of struggle in Istanbul’s Taksim Square, is the demand for women’s liberation.

Coming from many walks of life and expressing a myriad of ideals and values, the women of the Occupy Gezi Movement have nevertheless voiced a collective desire: to fight the undercurrent of deeply entrenched patriarchal values and reclaim autonomy over their own bodies and lifestyles.

These demands are now coalescing around proposed legislation from the country’s Health Ministry that will call on pharmacies to limit the sale of oral contraception known as the morning-after pill only to those with a doctor’s prescription, a practice that is uncommon for most drugs available to the public here.

Under Turkey’s conservative-leaning Justice and Development Party (AKP) government, women are encouraged to have at least three children to help maintain population growth rates.

Feminists and women’s rights groups representing almost 400 people say the new legislation is part of government attempts to impose traditional values onto their lifestyle, and will only reinforce stereotypes about the “ideal” Turkish woman, while stigmatising those who stray from this image.

“I can’t go to the family doctor (for my contraceptive needs) because it is a secretive issue for me,” said Merve Kosar, a 26-year-old Istanbulite who relies on the pharmacy to replenish her supply of the drug.

In Turkey, most non-narcotic drugs are available for purchase over the counter. Insisting on a prescription from a family doctor, who can report to other members of the family, places added pressure on women to conform to conservative mores.

Women like Kosar, who make the conscious decision to have sex before marriage, are worried about having fewer options to guard against unwanted pregnancies.

Nearly 34 percent of once-married and currently married women said they use morning-after pills as their main form of contraception, according to the 2008 Turkey Demographic and Health Survey.

Still, the possibility of parliament passing the bill under a larger package of reforms sometime this year seems likely and concerns women’s rights groups who say the announcement will hinder some from asking pharmacies for pills.

An article in the Hurriyet Daily News cited a notice from the Health Ministry, which stated that “growth hormones, antibiotics, antidepressants, and antihistamines” must be sold with a doctor’s prescription to reduce the misuse of drugs.

According to Zerrin Guker, a pharmacist in the commercial neighbourhood of Karakoy who sells 15 to 20 boxes of the morning-after pill per month, some customers have been misusing the drug by purchasing it a few times per week, which can cause hormonal side effects.

A 27-year-old protestor named Elif, who declined to give her last name for fear of retribution, said she suffered blood clots and nausea after taking the pill once; yet she still believes in a woman’s right to choose and says the government’s proposed restriction is designed to prevent unmarried women from having sexual relationships.

“Most women can’t even buy tampons or feminine products from stores because they are ashamed,” she told IPS, stressing that the culture of shame has become entrenched in society.

A long fight to overturn these attitudes is slowly showing results: ideals about abstinence until marriage, for instance, are shrinking, as women continue to speak out about their grievances with men including harassment and sexist swearing, practices that have infiltrated the Occupy Gezi Movement.

At a recent meeting in Yogurtçu Park in Istanbul’s Kadikoy district, more than 100 women gathered to discuss their experiences at Gezi Park.

One protestor said a drunken man grabbed her buttocks one night, while bystanders justified his actions saying he had been under the influence.

Another woman read out a list of complaints with the governing party, which included attempts to get rid of “dekolte” (low-cut dresses) and state attempts to ban abortions and “keep women at home.”

A year ago, Prime Minister Recep Tayyip Erdogan called for tighter restrictions on reproductive health by drafting a bill that would shorten the time period in which women can have an abortion from 10 weeks to eight weeks.

“There is no difference between killing the foetus in a mother’s womb or killing a person after birth,” Erdogan said in a speech before female politicians in the capital, Ankara, last year.

His words drew the ire of around 3,000 to 4,000 protestors, mostly women, who marched against the anti-abortion law in Kadikoy last June, waving banners proclaiming statements such as: “It is my body, so who are you?”

When abortion became legal in 1983, the Turkish Population and Health Survey found that 37 percent of once-married Turkish women had at least one abortion. As of 2008, that figure stood at 14.8 abortions per 1,000 women.

While the latest call to limit oral contraception has yet to spark demonstrations, many believe it will eventually ignite the tensions that have been simmering for years now.

Ayse Dunkan, journalist and activist, believes the outcry will pick up momentum, with more people rebelling against the “conservative concept (that) women (must) stay home and raise children.”

Such ideals, she told IPS, have resulted in Turkey having the world’s second highest population growth rate after China.

Selime Buyukgoze, a volunteer at Mor Cati, an Istanbul-based network for battered women, called the proposal “problematic” since the morning-after pill must be taken within 72 hours of having unprotected sex and few women will be able to reach their doctors that soon.

Like most others, though, her biggest fear is that doctors will break a woman’s confidence by reporting her lifestyle to the family.

Ahmet Kaya, a family doctor who sees almost 150 patients a week, rebukes that claim. “If your patient doesn’t want you to inform her family, you can’t make that call,” he told IPS.

At the moment, pharmacies are continuing to sell the pill without asking for a prescription

It remains to be seen whether or not the government will push ahead with the law, or whether it will respond to the will of more than 1.5 million female protesters.

Carina Vance: “Our constitution guarantees free access to services, contraceptive methods and family planning visits.” Credit: Courtesy of Health Ministry of Ecuador

By Leisa Sánchez
QUITO, Apr 19 2013 (IPS)

The government of Ecuador is determined to curb the growing number of teen pregnancies, and has begun to knock down barriers that stand in the way of the right to a responsible sexual and reproductive life.

The question of sexual and reproductive health has been a focus of public debate since new regulations were announced on availability and access to birth control methods, including emergency contraception known as the morning-after pill.

Making emergency contraception freely available forms part of the National Multi-Sector Strategy for Family Planning and Teen Pregnancy Prevention (ENIPLA), which has been given a budget of 4.4 million dollars.

Ecuador has the highest teen pregnancy rate in South America: 81 births per 1,000 females between the ages of 15 and 19. Seventeen percent of girls in that age group have at least one child. And the number is on the rise: according to official figures, the number of births to adolescents in that age group rose from 31,053 in 2004 to 45,708 in 2011.

The Catholic Church and other critics claim the morning-after pill is an abortifacient, even though studies show that what the pill actually does is delay ovulation.

The pill has been legally available in Ecuador since 1998, but a prescription was needed. Today it is freely available, without cost, in all public hospitals and health centres in this South American country.

Public Health Minister Carina Vance discussed the ENIPLA strategy, its achievements and challenges with IPS.

Q: Why was the decision reached to make the morning-after pill freely available?

A: We have disturbing statistics with respect to family planning and the spacing of children, in terms of the number of desired children and how many people actually have.

ENIPLA, a joint programme of the ministries of education and economic and social development, has been implemented since 2011 in Ecuador, which has the highest teen pregnancy rate in South America.

Q: Is the controversy over the morning-after pill based more on moral values than on knowledge of rights?

A: We believe there is no real controversy, because there is actually wide acceptance, of ENIPLA and of the fact that the method is freely available.

We have received a favourable response from social organisations and national and international institutions involved in health and women’s rights. The great majority of opinions against (the morning-after pill) are not based on scientific information, but on a mistaken understanding.

They claim that in some cases, emergency contraception is abortive, but there is scientific evidence that it is not. And they also want parental consent in order for an adolescent to have access to birth control methods.

Q: Are young people in Ecuador mature enough to decide on their own?

A: If young people are mature enough to have sexual relations, we have the obligation to respect their right to unlimited access to the pill, without barriers or the approval of third parties. We believe in working with parents to strengthen family communication on sexuality and sexual and reproductive rights.

There are people who because of principles or religious beliefs don’t consider it appropriate to make this kind of contraceptive freely available. We completely respect that position, but we have to integrate public policies in a framework of rights, and understand that the Ecuadorean state is secular.

Q: How many health centres distribute the emergency contraception pill?

A: We have 1,900 units nationwide.

Q: With respect to the promotion of a responsible reproductive and sexual life, what efforts are needed?

A: The Health Ministry has the obligation to provide objective, science-based evidence and provide medication totally free of charge. For example, we have condom dispensers in our health units, but that’s not enough.

Multi-sectoral work is needed, which is why it is so important to work with the Education Ministry. And there is also the shared responsibility of society: conversations on sexuality and rights should not be limited to visits to health centres. We also work with the parents of young people.

We carry out an ongoing effort in prevention, attention and studies on sexually transmissible diseases and the various problems that influence their spread.

We definitely have challenges: high teen pregnancy rates; the fact that 13 percent of maternal deaths occur among adolescents between the ages of 15 and 19; and the fact that six out of 10 women overall have suffered some kind of violence: physical, psychological or sexual.

We also face big challenges in achieving an equitable society free of violence, where sexual and reproductive rights are fully respected.

Q: Does this mark a watershed in sexual and reproductive rights?

A: Use of the emergency contraception pill has been legal since March 1998. With these latest regulations, we are now guaranteeing access to the pill without a prescription, as well as adequate supplies in all public health centres and hospitals, and the exercise of the right to a birth control method without parental or partner consent, a requirement that used to be a barrier for women.

Our constitution guarantees free access to services, contraceptive methods, family planning visits, and the possibility for everyone to lead a healthy life with universal access to health care, with a central focus on primary care.

Q: How does the government plan to move forward in the struggle to consolidate sexual and reproductive rights?

A: I don’t know if I would call it a struggle. A 2011 survey found that 84 percent of respondents agreed with the free provision of birth control methods – in other words, we have a high level of acceptance, and a government that is totally committed to the exercise of rights, including sexual and reproductive ones.

We are going to do everything necessary to implement sustainable policies, to make sure there is no backsliding.

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